Spatial and Social Inequalities in the Face of Death: Pilot Research on Cholera Epidemics in Poznań of the Second Half of the 19th Century

HSR Supp 33 2021_Spatial and Social Inequalities in the Face of Death. Pilot Research on Cholera Epidemics in Poznán of the Second Half of the 19th Centurywww.ssoar.info
Spatial and Social Inequalities in the Face of Death: Pilot Research on Cholera Epidemics in Pozna of the Second Half of the 19th Century Liczbiska, Grayna
Veröffentlichungsversion / Published Version Zeitschriftenartikel / journal article
Zur Verfügung gestellt in Kooperation mit / provided in cooperation with: GESIS - Leibniz-Institut für Sozialwissenschaften
Empfohlene Zitierung / Suggested Citation: Liczbiska, G. (2021). Spatial and Social Inequalities in the Face of Death: Pilot Research on Cholera Epidemics in Pozna of the Second Half of the 19th Century. Historical Social Research, Supplement, 33, 37-55. https:// doi.org/10.12759/hsr.suppl.33.2021.37-53
Nutzungsbedingungen: Dieser Text wird unter einer CC BY Lizenz (Namensnennung) zur Verfügung gestellt. Nähere Auskünfte zu den CC-Lizenzen finden Sie hier: https://creativecommons.org/licenses/by/4.0/deed.de
Terms of use: This document is made available under a CC BY Licence (Attribution). For more Information see: https://creativecommons.org/licenses/by/4.0
Spatial and Social Inequalities in the Face of Death.
Pilot Research on Cholera Epidemics in Pozna of
the Second Half of the 19th Century
Grayna Liczbiska
Abstract: »Räumliche und soziale Ungleichheiten im Angesicht des Todes. Eine Pilotstudie über Choleraepidemien in Pozna in der zweiten Hälfte des neun-
zehnten Jahrhunderts.« In the second half of the 19th century, various quarters of Pozna differed in terms of infrastructure, including access to clean water.
This paper aims to analyse whether these spatial and social inequalities re- lated to the quarter of residence in the city, and thereby whether access to san-
itary infrastructure and clean water intake, and in general, differences in living conditions, influenced the probability of death from cholera. Data from four
cholera epidemics – 1852, 1855, 1866, and 1873 – were used for this purpose.
In total, 16,285 individual data entries from death registers of Catholic and Protestant parishes were used regarding such information as the date of
death, sex, age at death, cause of death, profession, religion, and exact ad- dress of residence. There was a significant relationship between socioeco-
nomic factors (quarter of residence, denomination, professions) and biologi- cal factors (sex and age at death), and the distributions of deaths due to
cholera and other causes. Generalized Linear Models (GLMs) revealed that liv-
ing in the Old Market Square did not decrease the chance of death from chol- era, and on the other hand, living on the right bank of the Warta River did not
increase the chance of death from cholera. In other words, better quarter of residence did not guarantee lower morbidity and did not protect from cholera
and vice versa. This work also proves a significant interaction between the quarter of residence and such variables as denomination and occupation on
probability of death from specific cause. Virtually until the end of the 19th cen-
tury, the sanitary conditions in Pozna were so poor that they were conducive
to epidemics of infectious diseases.
Keywords: Epidemics, quarter of residence, profession, denomination, city in-
frastructure, urban ecology, water intakes, Poland, Pozna.
Grayna Liczbiska, Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickie-
wicz University, Pozna, Uniwersytetu Poznaskiego 6, 61-614 Pozna, Poland; [email protected].
1. Introduction
Cholera is a disease caused by gram-negative Vibrio cholerae. So far, over 200 serogroups of V. cholerae strains have been identified (Chatterjee and Chaudhuri 2003). Among the strains of V. cholerae, two biochemical varieties have been distinguished: V. cholerae O1 classical type – the etiological factor of six pandemics – and V. cholerae type El Tor – the factor of the seventh most recent cholera pandemic (Harris et al. 2012; Hu et al. 2016). For epidemiolog- ical purposes, the O1 strains include three antigenic varieties: Ogawa (the most common), Inaba (less common), and Hikojima (the least common). In- itially, only the O1 antigenic type was considered a pathogenic variant of chol- era. Meanwhile, research in Kolkata found that there are 139 different groups of the somatic O antigen, including type O 139, which also can produce chol- era toxin and was the cause of the cholera epidemic in India (Naruszewicz- Lesiuk and Stypukowska-Misiurewicz 2017). V. cholerae transmission may oc- cur through a faecal-oral route (“person to faeces to person”) or from the en- vironment (environmentally acquired infection; Ganesan, Gupta, and Legros 2020). Symptoms include watery diarrhoea, which leads to dehydration and low electrolyte level (Kappner 2019). About 10-20% of cholera infections are symptomatic and present as mild diarrhoea symptoms, while about 20% of cases are severe, so without rapid and adequate hydration and electrolyte re- placement and antibiotic therapy, they can lead to death (Kappner 2019).
In the past, cholera spread from the Delta of Ganges six times and caused six pandemics: 1817–1823, 1826–1838, 1846–1863, 1865–1875,1883–1896, and 1899–1923. However, endemic cases of epidemics were recorded in India as early as the 18th century (Cvjetanovic and Barua 1972). In 1817, a cholera ep- idemic broke out in the Ganges Delta, quickly swept over the Indian Penin- sula, and spread towards the Near and Far East. The year 1817 was considered the time of “birth” of the first cholera pandemic. The first wave of the pan- demic reached Europe in the 1820s (within Russia in 1823; Czapliski 2012). In 1826, another cholera epidemic broke out in Bengal, which led to the sec- ond wave of the pandemic (1826–1838). In 1831, the pandemic covered almost the whole territory of Russia and soon reached the Kingdom of Poland (the Polish lands under the Russian partition) and Germany. In the same and the following year, the epidemic continued to spread to Galicia (the Polish terri- tories under the Austrian rule), Hungary, and Bulgaria. It moved from Ham- burg to England in 1832, and from England to France and Ireland. Then it spread to the rest of Europe, to Africa, and to both Americas (Czapliski 2012). Since 1839, there was no cholera in Europe, while in 1846 it began to push again towards Europe (the third wave, 1846–1863). In the fall of 1847, it was already in Moscow, and at the end of the year in the Kingdom of Poland, from where it got to Prussia in 1848. In the following years it covered Europe
HSR Suppl. 33 (2021) 39
(northern Europe in 1853), North America, and Mexico, and at the end of the pandemic, in 1863, it reached Brazil (Czapliski 2012). The next wave of the pandemic appeared in Europe and Asia in the 1860s and lasted until the 1870s (1865–1875). Until 1884, Europe was cholera-free. In 1883, the cholera epi- demic broke out in India again and quickly spread to Persia, Arabia, and Egypt. Then it continued on its way to Europe with great force. It was the fifth wave of the cholera pandemic (1883–1896). Cholera was brought from Italy to both Americas (Czapliski 2012). The last wave of the cholera epidemic in the 19th century, in 1899–1923, began in India in 1892. It reached Russia in 1892 and from there it moved west. The year 1896 was considered the end date of the 19th century cholera pandemics. According to estimates, all cholera pan- demics in the 19th century resulted in 30 to 40 million deaths (Czapliski 2012).
Cholera epidemics did not omit Poland. In Pozna, in the first half of the 19th century, they broke out three times: in 1831, 1837, and 1848 (Kaniecki 2004). Researchers have paid a lot of attention to the first two epidemics, es- pecially to the one of 1831 (Gerstenberger and Stasch 1935; Kaniecki 2004; Stasch 1933; Trzeciakowska and Trzeciakowski 1987). Meanwhile, cholera ep- idemics returned to Pozna in the following years, with subsequent waves: 1852, 1855, 1866, and 1873. Due to the epidemic waves, in the third and fourth decades of the 19th century, the city already had a lot of experience in dealing with cholera in the next outbreaks. Meanwhile, the fact that the city was closed within the walls of the fortress, high population density and practically low sanitary level lasting until the end of the century made each subsequent outbreak of cholera a great challenge for the city (Kaniecki 2004).
Researchers, based on diaries, newspaper articles, and published memoirs of people involved in the fight against cholera epidemics and on the numbers of deaths, state that the morbidity and mortality cases from cholera were un- equally distributed in Pozna, i.e., differed between quarters in the city (Ger- stenberger and Stasch 1935). This was related to the diversity of the quarters of Pozna in terms of urban infrastructure, including access to clean water and the socioeconomic status of city residents, etc. (Kaniecki 2004; Kdelski 1994; Liczbiska 2009a, 2009b, 2011, 2015; Trzeciakowska and Trzeciakowski 1987). However, the problem of spatial and social stratification of mortality from cholera in Pozna has not been elaborated in more detail. The proposed work tries to meet these shortcomings. The aim of the study was to investi- gate, using statistical tools, whether spatial and social inequalities in Pozna, translating into differences in access to sanitary infrastructure, clean water intake, and generally, ecological conditions and standards of living, resulted in a varied probability of dying from cholera.
HSR Suppl. 33 (2021) 40
2. Data
According to the resolutions of the Congress of Vienna (February 1815), the city of Pozna became the capital of the Grand Duchy of Pozna, which was a part of the Prussian state in territorial and administrative terms (Kdelski 1994). Since 1848, after the creation of the Province of Pozna (German: Provinz Posen) from the Grand Duchy, Pozna became the capital of this Prov- ince (Kozowski 2004). In the first decades of the 19th century, Prussian au- thorities decided to turn Pozna into a fortress surrounded by walls (figure 1).
Figure 1 Map of 19th-Century Pozna
Source: Plany Miasta Poznania 1870-1944: https://cyryl.poznan.pl/kolekcja/633/plany-poznania- 1870-1944-ptpn (Accessed September 6, 2021).
The Old Market Square The City Centre
The right bank of the Warta River Area outside the fortification
This decision inhibited the city’s demographic growth within the walls for the next decades (Trzeciakowska and Trzeciakowski 1987). In 1867, the city had 53,400 inhabitants; in 1875, 61,000; in 1880, the population of Pozna in- creased to 65,700; and only at the beginning of the 19th century (1900), after the demolition of fortifications and the inclusion of quarters located outside
HSR Suppl. 33 (2021) 41
the walls to the city, to 117,000 (Statystyczna Karta Historii Poznania 2008, 53). In 1895, the population density in Pozna was over 7,700 people per km2, and after the incorporation of such quarters as Wilda, St. Lazarus with Górczyn, and Jeyce, it fell to 3,500 people per km2 (Statystyczna Karta Historii Poznania 2008, 53).
Table 1 Descriptive Information Concerning Cholera Epidemics in the City of
Pozna, the Second Half of the 19th Century Year of epidemic
No. of deaths due to cholera
The onset of the epi- demic
The end of the epi- demic
The highest monthly tem- perature in summer (°C)3
No. of days with heat waves4
VI VII VIII IX 18521 1556 22 Jul 30 Sep 29.5 30.0 28.5 24.0 34:
5 (May) 7 (Jun) 14 (Jul) 8 (Aug)
18552 2211 21 Jul 6 Dec 31.6 29.3 30.8 22.3 18: 8 (Jun) 4 (Jul) 6 (Aug)
18661 1344 18 Jun 22 Oct 32.5 28.9 28.5 28.5 34: 17 (Jun) 5 (Jul) 5 (Aug) 7 (Sep)
18731 60 23 Jul 6 Dec 26.8 30.5 32.6 23.8 – 1 The onset and the end of the epidemic and the numbers of deaths after: Cyfrowe Lapidarium
Poznania 2021. 2 The onset and the end of the epidemic and the numbers of deaths after (Dzierawski et al. 1892, 7). 3 Temperatures derived from (Smosarski 1925, 118-9). 4 Information on the numbers of days with heat waves derived from (Smosarski 1925, 127).
The work used individual data entries on deaths from parish books of Pozna parishes of Catholic denomination: St. Mary Magdalene, St. Margaret, St. Martin, St. Roch, and parishes of Protestant denomination: St. Peter and the Holy Cross. The books for 1850–1874 were used and thus the data for 4 cholera epidemics in 1852, 1855, 1866, and 1873 in all parishes were gathered. Infor- mation about the onset and the end of each cholera epidemic in Pozna and the numbers of victims in the city were presented in Table 1. The initial data- base included 24,831 individual pieces of information on the date of death, sex, age at death, cause of death, profession (in the case of children – the par- ent’s profession, and in the case of unemployed women – the husband’s pro- fession), religion, and place of residence.
HSR Suppl. 33 (2021) 42
3. Methods
Individuals with the exact address of residence were selected from the data- base for further analysis. Thus, ultimately the database consisted of 16,285 individual data entries including information concerning names and sur- names, sex, ages at death, causes of deaths, denomination, professions, and addresses of deceased. The exact address of residence included the name of the street, sometimes the name of the street and the house number, which allowed the person to be assigned to one of the 4 categories distinguished within the variable “quarter of residence” (see figure 1):
0) The Old Market Square – gathering people living around the market square and neighbouring streets, such as Kozia, Klasztorna, Wona, Wielka, lusarska, Kramarska, Mokra, Dominikaska, etc. The ecolog- ical situation in this part was better than anywhere else in Pozna. Peo- ple living in the vicinity of the market square were privileged in terms of access to clean water, and sewage in this part of the city was dis- charged through underground channels (Kaniecki 2004).
1) The city centre, as well as Piotrowo and Berdychowo belonged to the area, which was surrounded by the fortress. The city centre was inhab- ited by wealthier Pozna residents. Unfortunately, at the end of the 19th century, this part of the city was virtually “suffocating within the walls” due to the lack of free space and high population density (Kaniecki 2004).
2) Quarters located on the right bank of the Warta River: ródka, Ostrówek, Zawady, Chwaliszwo, Ostrów Tumski. It is worth mentioning that ródka, Ostrówek, Ostrów Tumski, and Chwaliszwo were also within the fortress, but the very low standard of living of the inhabitants and the lack of infrastructure in this area (Kaniecki 2004; Karolczak 1997a, 1997b) led to excluding them from category 1 and appointing to the category of “right-bank quarters.”
3) The city area outside the fortress, attached to Pozna after 1900. This area included the following quarters: Górczyn, Jeyce, Wilda, and Lazarus. The lands outside the fortress walls were characterized by a lower population density and better ecological conditions than in the city centre (Budziaowska and Górna 2014).
The historical index of street names in 19th-century Pozna was used (Nezboraa 2010). Another variable distinguished in this work is “religious denomination,” within which 2 categories were distinguished: 0) Protestants; 1) Catholics.
The work also uses information about the profession of the deceased; in the case of children, information about the father’s profession; and in the case of women without a given profession, information about the husband’s
HSR Suppl. 33 (2021) 43
profession provided in the death record (e.g., wife of a shoemaker, widow of a locksmith, wife of a worker). In relation to historical and contemporary populations, profession is a commonly used indicator of socioeconomic sta- tus. This indicator was associated with differences in the standard and quality of life and influenced the stratification of demographic and biological char- acteristics (e.g., Liczbiska et al. 2017, 2018; opuszaska et al. 2016). In this paper, profession was considered a proxy for socioeconomic position of Poz- na citizens. The variable “profession” included 4 categories: 0) Workers (skilled and unskilled workers, daily laborers, etc.); 1) Craftsmen (shoemak- ers, carpenters, tailors, etc.); 2) Workers in the service sector (service, carri- ers, guards, servants); 3) White-collar workers (doctors, lawyers, professors, pharmacists, teachers).
Another variable is “age at death,” within which 6 categories were distin- guished: 0) ≤14 yrs.; 1) 15-24 yrs.; 2) 25-34 yrs.; 3) 35-49 yrs.; 4) 50-59 yrs.; 5) ≥60 yrs. “Causes of deaths” were divided into: 0) deaths from other causes; 1) deaths from cholera. The Chi-squared test was used to verify whether there were any differences between socioeconomic variables (religious denomina- tion, quarter of residence in Pozna, profession) and biological variables (sex, age at death), and the frequencies of deaths due to cholera and “other causes.”
It was verified whether the quarter of residence influenced death from a specific cause with denomination and occupation as covariates. MANCOVA was applied for this purpose. Generalized Linear Models (GLMs) with bino- mial error distribution and the logit link function were used to examine whether a quarter of residence in Pozna, and thus the achievements of civi- lization, infrastructure in the quarter, the status of its residents, etc., was (or not) significantly associated with probability of death due to cholera. The de- pendent variable took two values: if the death occurred from “cholera”: 1 and 0 in the case of death from “other causes.” “Quarters of residence in Pozna” were explanatory variables (4 quarters = 4 separate variables). A given quarter was a separate explanatory variable marked as 1 (the event of interest to us) while other quarters (places of residence) in the column for this variable were marked as 0. The odds ratios and their 95% confidence intervals (CI) were calculated to characterize the effect of the explanatory variable on the binary response. Odds ratios helped to assess the chance of deaths due to cholera depending on the distinguished categories of the place of residence in Pozna (the quarter of Pozna). To assess test efficiency, receiver operating charac- teristics (ROC) and areas under curves (AUC) were calculated. ROC curve is a graphical representation of the relationship between true positive percent- ages of results and false positive percentages of results. The area under ROC- AUC curve, ranging from 0 to 1, determines the test’s ability to distinguish between normal and abnormal results. The greater AUC value (the more
HSR Suppl. 33 (2021) 44
concave the ROC function is), the greater the diagnostic power of the test, and thus the better the resolution of the test (Stanisz 2007).
All statistical analyses were carried out using STATISTICA version 13.3 (StatSoft, Inc. 2019). Significance was set at p<0.05 and p<0.0001.
4. Results
The relationship between the categories of the following variables: sex, quar- ter of residence, religious denomination, profession, age at death, and the frequencies of deaths due to cholera (and other causes) were presented in Ta- ble 2.
Table 2 The Relationship Between Sex, Quarter of Residence, Religious Denomination, Profession, and Age at Death by Cause of Death;
Chi2 test values
p<0.0001 Female 53.41 48.82
Denomination Catholics 72.40 64.22 42.28; df=1
p<0.001 Protestants 27.60 35.78
City district
City centre 52.78 37.99
Right bank 30.28 34.23
Profession
Craftsmen 34.04 33.64
Servants 18.01 23.10
15-24 yrs. 6.69 4.04
25-34 yrs. 14.33 6.55
35-49 yrs. 18.80 11.18
50-59 yrs. 9.40 6.41
≥60 yrs. 9.53 11.22
Women more frequently died due to cholera than men (Ch2= 11.75, df=1, p<0.0001). There were higher frequencies of deaths from cholera among Catholics than among Protestants (Ch2= 42.28; df=1; p<0.001). The frequencies of deaths due to cholera were unequal in the quarters of residence in Pozna (Ch2=108.85; df=3; p<0.0001): the greatest frequency of deaths from cholera was recorded in the city centre (almost 53% of all deaths from cholera) and
HSR Suppl. 33 (2021) 45
on the right bank of the Warta River (30% of all deaths from cholera). Deaths from cholera in the Old Market Square and outside the fortress walls amounted to less than 10% of all deaths from cholera in 4 analysed city quar- ters. There was also…